Bhavishya Surapaneni Clark, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

155364 Issued in CA

Practice address

35 Casa St Ste 130
San Luis Obispo, CA 93405-1887

Phone

(805) 541-1422

Fax

(805) 541-1215

NPI assigned

May 14, 2016

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pain Management

Education

New York Medical College, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Sierra Vista Hospital, San Luis Obispo, CA, CCN 050506
• French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
• Adventist Health Twin Cities Hospital, Templeton, CA, CCN 050633

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

64.37

Promoting interoperability

100

Improvement activities

40

Cost

72.88

Merit-based Incentive Payment System (MIPS)

Final score

95.77 of 100Reported as apm

Quality

81.54

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bhavishya.clark.1@31068.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment Care Compare group NPD
• First Choice Physician Partners

  dba Greater Modesto Medical Surgical Associates

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Family Medicine Physician
  • Arroyo Grande, CA
  • NPI 1306604681
  NPD
• First Choice Physician Partners

  dba Rocky Balch, MD

  • Surgery Physician
  • Placentia, CA
  • NPI 1134466642
  NPD
• First Choice Physician Partners

  dba De La Pena Eye Clinic, A Medical Group

  • Ophthalmology Physician
  • El Monte, CA
  • NPI 1912732892
  NPD
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  dba French Hospital Medical Center

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1881760452
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation
• Sierra Vista Hospital, Inc.

  dba Sierra Vista Regional Medical Center

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1639101116
  Care Compare affiliation
• Twin Cities Community Hospital, Inc.

  dba Twin Cities Community Hospital

  • General Acute Care Hospital
  • Templeton, CA
  • NPI 1396778197
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1144677691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CASA ST STE 130",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051887",
            "telephone_number": "805-541-1422",
            "fax_number": "805-541-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CASA ST STE 130",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051887",
            "telephone_number": "805-541-1422",
            "fax_number": "805-541-1215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St",
            "address_2": "Clinic tower, Ste A7D",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-442-4830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BHAVISHYA",
        "middle_name": "SURAPANENI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-14",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "155364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Cirisan
• Kevin Cirone, LPT
• City of San Luis Obispo
• Gerald Eugene Clare, LCSW
• Alia Kehaulani Clark
• Elizabeth Clark, AMFT
• Madison Malia Clark
• Rebecca Dawn Clark, APCC
• Shannon Clark
• Matthew William Clarke

• Otolaryngology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.